Vol 343, No 5 (2022)

The article discusses the essence and content of medical support in the conduct of hostilities in modern conditions in a single information network. Built on the old, outdated approach to building large institutional or regional medical information systems, the management system has ceased to meet modern requirements. A modern military medical information system for officials of the medical service of the Armed Forces must flexibly adapt to changing requirements, be able to quickly configure and connect new services (subsystems) and provide new services. In addition, it must have an architecture that can work stably when the failure of individual services (subsystems) or software and hardware systems will not adversely affect medical provision and management of the medical service.

The results of an experimental study on the establishment of the mechanism of fragmentation and distribution of fragments of a firearm in a target when fired with 5.45×39 cartridges from the Saiga hunting carbine and 5.45 PS (7N6) from the AK-74 assault rifle through triplex on ballistic gel and tissue targets from a distance are presented. 5–10 m. The course and results of the experiments were recorded using high-speed video recording (1–12 thousand frames/s). The deformed bullets and their fragments were examined using a Leica M125 microscope, a Hitachi FlexSem1000 II scanning electron microscope, and a Bruker Quantax 80 energy dispersive X-ray spectrometer. The study showed that in cases of projectile fragmentation when penetrating a triplex, the dispersion of fragments and their distribution in the target are due to the phenomenon of normalization of the flight trajectory of a firearm projectile in an obstacle: the lower the velocity of the projectile fragment, the greater its deviation towards the normal.

Hospital-replacing technologies allow medical organizations to improve the efficiency and quality of medical care provided, as well as ensure the efficient use of the bed fund and are a reserve for saving resources. The experience of organizing and providing hospital-replacing surgical care in the Federal State Budgetary Institution «52 Consultative and Diagnostic Center» of the Ministry of Defense of the Russian Federation is presented. The procedure for selecting patients, preoperative preparation, anesthetic management, postoperative management of patients in a day hospital, as well as factors that can significantly reduce the cost of treatment and reduce the period of disability are considered. The data on surgical interventions of the «hospital registry» performed in the consultative and diagnostic center are given.

If signs of a tuberculous process in the lungs are found on fluorograms or radiographs of the chest, its clinical form should be established. The rounded nature of the formation is often observed with pulmonary tuberculoma, but it also occurs with tuberculous infiltrate, focal pulmonary tuberculosis, especially with a conglomeration of foci. The differential diagnostic differences between tuberculoma and other tuberculous formations in the lungs and rounded formations in extrapulmonary processes are considered. An algorithm of diagnostic measures is presented.

The treatment of comorbid patients with heart failure is traditionally associated with a high probability of polypharmacy and the realization of undesirable drug effects. The choice of management tactics for patients who have recently undergone cardiac surgery with a high risk of both thrombotic and hemorrhagic complications against the background of concomitant hematological pathology seems to be especially controversial. This paper presents the results of long-term clinical observation of a patient with a deficiency of VIII, IX factors of blood coagulation, cardiorenal anemic syndrome, performed by implantation of a pacemaker and stenting of the coronary artery. The tactics of managing such patients from the standpoint of evidence-based medicine are discussed.

A survey of 100 healthy servicemen aged 18 to 30 years was carried out using a random sample. Class G specific immunoglobulins to hepatitis A virus and hepatitis B virus (anti-HBs, anti-HBc-IgG) have been identified. Regarding hepatitis A, 87% of the examined were seronegative and only 12% had specific immunoglobulins. This indicates a high susceptibility of the military personnel of the surveyed group to the hepatitis A virus, which can create prerequisites for the occurrence of both sporadic and outbreaks of this infection. It was found that 71% of the examined protective antibodies to the hepatitis B virus, 16% of them had high titers. 29% of individuals were unprotected from hepatitis B. In the studied «anti-HBc» group, antibodies were absent in all military personnel; therefore, there were no potential sources of hepatitis B infection in it. The absence or weakening of vaccine immunity increases the risk of infection with viral hepatitis A and B.

A clinical case of tachycardiomyopathy induced by atrial fibrillation of the tachysystolic form is presented. The disease was accompanied by a rapid decrease in the left ventricular ejection fraction within 1 year, documented in various medical institutions. The restoration of sinus rhythm and the appointment of optimal drug therapy, combined with a high patient adherence to treatment, led to the restoration of the contractile function of the left ventricle within three calendar months.

A study was conducted to evaluate the effectiveness of combined and separate use of bischofite and shock wave therapy in plantar fasciitis. It has been shown that the combination of these methods is more effective than monotherapy in terms of elimination of soft tissue inflammation, softening of the calcaneal «spur» and relief of pain in the calcaneal region that occurs or increases with exercise. It is suggested that some pharmacological and natural remedies can be administered through intact skin during the shock wave therapy procedure.

The article presents the features of the organizational, supply and production activities of pharmaceutical specialists of military pharmacies during the Great Patriotic War 1941–1945. The characteristics of the staff of military pharmacies are given, the features of their placement and equipping with technological equipment are disclosed. The professionalism of the staff of military pharmacies is shown, which, in the most difficult conditions, selflessly worked at the front and in the rear, saving the lives and health of the wounded and sick soldiers, bringing the Victory closer.

The article is devoted to the work of the editors of the «Military Medical Journal» in 1943–1944. The circumstances of the return in 1944 to the journal of its historical name are considered, as well as the first publications in the new journal column «From the history of military medicine». The exchange of front-line experience on the pages of the journal not only helped many military doctors during the Great Patriotic War of 1941–1945, but can also serve Russian military medicine today. New information about the biography of the editor-in-chief in 1941–1945 is given. Colonel of the Medical Service, S.M. Baghdasaryan.

Based on the S.M. Kirov Military Medical Academy, on October 7–8, 2021, the All-Russian Scientific and Practical Conference «Theoretical and Practical Issues of Clinical Dentistry» was held. The conference was organized for the first time by the department and clinic of general dentistry, established in 2015. The forum was attended by military dentists of the Western Military District, representatives of the dental community in Moscow and St. Petersburg, as well as other cities of Russia, heads of departments, faculty, and students of the Military Medical Academy and other universities of Russia – over 200 people. The reports of the participants were devoted to scientific achievements and scientific and practical research on topical issues of dentistry, improving the methods of diagnosis, treatment, and prevention of oral diseases, etc.